Hans-Martin Sass, Honorary Professor of Philosophy. Founder and board member of the Centre for Medical Ethics, Bochum, Germany. Honorary Senior Research Fellow at Kennedy Institute of Ethics at Georgetown University, Washington, DC. Honorary Professor of the Bioethics Research Centre, Beijing. He has written more than 60 books and pamphlets, more than 250 articles in professional journals. Editor of the Ethik in der Praxis/ Practical ethics, Muenster: Lit. Founder and co-editor of the brochures “Medizinethische Materialien”, Bochum: ZME. He has lectured in (...) Argentina, Austria, Belgium, Bulgaria, Brazil, Canada, Croatia, the Chech Republic, India, Iran, Israel, Italy, Japan, France, the Netherlands, the Philippines, Poland, Portugal, Russia, Spain, Switzerland and Taiwan. The interview devoted to exposition of the concept of bioethics in America and Germany, as well as the professor`s attitude to the idea of the integrative concept of bioethics. The concept of integrative bioethics has been developed in different countries, a component of this concept is the idea of the need for discussion on bioethics in various sectors of society. Equally important in this concept are the definitions of bioethics and the bioethical imperative proposed by Fritz Jahr in 1926. The scientist`s article, which was discovered in 1997, contains a new format of bioethical ideas, as well as a valuable opportunity to enhance understanding the term of bioethics as an integrative science. Interview has been conducted by Hanna Hubenko as a part of the joint international course «Integrative Bioethics». At the meeting it was discussed the experience of cooperation and plans for the future. Cooperation and feedback between scientists remains an unconditional prerogative, also in a pandemic situation. (shrink)

Madness and Modernism provides a phenomenological study of schizophrenic disorders, criticizing some standard conceptions of these disorders. Sass argues that many aspects of this group of disorders can actually involve more sophisticated (albeit dysfunctional) forms of mind and experience.

In recent years, there has been much focus on the apparent heterogeneity of schizophrenic symptoms. By contrast, this article proposes a unifying account emphasizing basic abnormalities of consciousness that underlie and also antecede a disparate assortment of signs and symptoms. Schizophrenia, we argue, is fundamentally a self-disorder or ipseity disturbance that is characterized by complementary distortions of the act of awareness: hyperreflexivity and diminished self-affection. Hyperreflexivity refers to forms of exaggerated self-consciousness in which aspects of oneself are experienced as akin (...) to external objects. Diminished self-affection or self-presence refers to a weakened sense of existing as a vital and self-coinciding source of awareness and action. This article integrates recent psychiatric research and European phenomenological psychiatry with some current work in cognitive science and phenomenological philosophy. After introducing the phenomenological approach along with a theoretical account of normal consciousness and self-awareness, we turn to a variety of schizophrenic syndromes. We examine positive, then negative, and finally disorganization symptoms—attempting in each case to illuminate shared distortions of consciousness and the sense of self. We conclude by discussing the possible relevance of this approach for identifying early schizophrenic symptoms. (shrink)

Impairments in cognitive coordination in schizophrenia are supported by phenomenological data that suggest deficits in the processing of visual context. Although the target article is sympathetic to such a phenomenological perspective, we argue that the relevance of phenomenological data for a wider understanding of consciousness in schizophrenia is not sufficiently addressed by the authors.

This paper considers contradictory features of emotional or affective experience and expression in schizophrenia in light of the “Kretschmerian paradox”—the fact that schizophrenia-spectrum patients can simultaneously experience both exaggerated and diminished levels of affective response. An attempt is made to explain the paradox and explore its implications. Recent research on emotion in schizophrenia is reviewed, including subjective reports, psychophysiological measures of arousal or activation, and behavioural measures, focusing on flat-affect and negative-symptom patients. After discussing relevant concepts and vocabulary of emotion (...) (“affect”, “emotion”, “mood”, “feelings”, the “passions”), the need for a phenomenological approach focusing on subjective experience is proposed. Four modes of nonparanoid experience in schizophrenia are discussed: Bodily Alienation, Disengagement, Unworlding, and Subjectivisation. Each mode involves withdrawal from functional contexts—temporal, practical, and interpersonal—normally associated with emotional reactivity and expression; each may be accompanied by forms of non-emotional affectivity no less intense than the emotions they replace. Possible relationships between psychophysiological measures, expressive behaviour, and subjective emotional or affective response are considered. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 11.1 (2004) 71-80 [Access article in PDF] Some Reflections on the (Analytic) Philosophical Approach to Delusion Louis A. Sass There are more things in heaven and earth, Horatio, Than are dreamt of in your philosophy." —Hamlet, Act I, Scene 5 The peculiar, often problematic phenome na of psychopathology have been attract ing the attention of analytic philosophers in recent years. The topic of delusion has (...) been a particular draw, with a number of analytic philosophers attempting to use their conceptual tools, usually combined with ideas from cognitive neuroscience, to criticize the traditional understanding and to clarify the nature of this central psychiatric topic. It is useful to have this kind of interdisciplinary dialogue. Indeed, there is good reason to hope that concepts honed in the philosophy of mind and other philosophical subfields will help to sort out our understanding of a phenomenon (or set of phenomena) for which contemporary psychiatric definitions and conceptualizations are clearly inadequate and, in some respects, downright misleading (see Parnas and Sass 2001; Spitzer 1990).1Here, however, I would like to call attention to some weaknesses that, it seems to me, are rather common (I do not say universal) in many analytic philosophical approaches to psychopathology. In my opinion, there is a tendency to formulate issues and arguments in overly polarized, even dichotomous terms, and then to rely too uncritically on these essentialistic formulations in exploring the domain of inquiry. Although this polarizing tendency sometimes has the salutary effect of clarifying conceptual domains, it can, when taken too far, actually hamper our understanding of phenomena that are often fraught with ambiguities and complexities that defy many standard conceptualizations.The relationship between philosophy and psychopathology is obviously a two-way street—we are familiar, for example, with disorders that challenge deep philosophical assumptions about self and mind (e.g., blindsight, split-brain phenomena, perhaps also Dissociative Identity Disorder, and the first rank symptoms of schizophrenia). I am suggesting that, in their work on delusions, philosophers may need to put more emphasis on moving from the natural phenomena [End Page 71] of psychopathology and to the domain of philosophical analysis.I believe that a greater sensitivity to the modes of knowing associated with the phenomenological tradition, and to the forms of conceptual self-critique fostered by Ludwig Wittgenstein, are crucial ingredients for any adequate approach to delusion as well as many other topics in psychopathology. In my opinion, the work of many analytic philosophers interested in psychopathology would be enriched if they spent more time trying to discover and imagine what it might be like to experience certain kinds of abnormal psychiatric conditions, and also speculating about what implications such experiential modalities might have for action and verbal expression. I believe they would also be wise to spend more time questioning, and attempting to transcend, the philosophically derived conceptual distinctions and dichotomies that appear to organize their conceptual universes. Phenomenological imagination and Wittgensteinian critique can show how to move outside the conceptual capsule and into the rich and strange realms of actual experience, both normal and abnormal.So far I have offered only slogans. Let me use the articles by Tim Bayne and Elisabeth Pacherie (2004) and Robert Klee (2004) to flesh out the criticisms I have offered. There is much that is intelligent and much that is worthwhile in both their articles. (For example, I was largely convinced by the criticisms of John Campbell and of Donald Davidson that are central to the articles by Bayne and Pacherie and by Klee, respectively.) Here, however, I will focus only on issues that illustrate the above-mentioned tendencies—tendencies that, in my view, tend to infect even the best writings on the (analytic) philosophy of psychiatry. I will also make some remarks about the works of Campbell and Davidson, the two philosophers criticized in the articles by Bayne and Pacherie and by Klee. Because the article by Eugenie Georgaca (2004) is in a different tradition, I will say only a few words about it at the end. Bayne and Pacherie on the Preservation-Of-meaning... (shrink)

Phenomenological psychiatry has suffered from a failure to translate its insights into terms specific enough to be applied to psychiatric diagnosis or to be used in contemporary research programs. This difficulty can be understood in light of the well-known tradeoff between reliability and validity. We argue, however, that with sufficient ingenuity, phenomenological concepts can be adapted and applied in a research context. Elsewhere, we have described a phenomenologically oriented conception of schizophrenia as a self- or ipseity-disorder with two main facets: (...) decline in the sense of existing as a subject of awareness (diminished self-affection) and heightened awareness of aspects of experience that would normally remain tacit or presupposed (hyperreflexivity). This approach is consistent with Minkowski, Blankenburg, and Kimura and offers one possible synthesis of their views. Here we describe two areas of empirical research that are congruent with, or actually inspired by, a phenomenological approach emphasizing such disorders of consciousness and self-experience: (1) Phenomenologically oriented, interview studies show that, whereas negative-symptom patients generally deny any diminishment of affect and thinking, they do describe qualitative alterations of experience suggestive of hyperreflexivity and diminished self-affection. (2) Another line of research suggests that the early detection of schizophrenic symptoms may be enhanced by adopting a phenomenological approach. (shrink)

The phenomenological approach to schizophrenia has undergone something of a renaissance in Anglophone psychiatry in recent years. There has been a proliferation of works that focus on the nature of subjectivity in schizophrenia and related disorders, and that take inspiration from the work of such German and French philosophers as Husserl, Heidegger, and Merleau-Ponty, and such classical psychiatrists as Minkowski, Blankenburg, and Binswanger (Rulf 2003; Sass 2001a, 2001b). This trend includes predominantly theoretical articles, which typically incorporate clinical material as well (...) as reviews of empirical and experimental findings in psychopathology. Some very recent examples (since 2000) are studies of .. (shrink)

The biological impact of electromagnetic radiation on humans and other living beings still is controversial and inconclusive. In 1935 Albert Einstein called such an impact ‘fake news’, probably using the prestige of the Nobel Price as a powerful placebo. How should he and we deal with issues of electrosmog, placebo effects, and fake news today?

The paper presents an overview of political and professional committees in the Federal Republic of Germany dealing with issues of biomedical ethics. The prevailing tendencies of paternalistic atittudes, the worst-casescenario argumentation method, and the unfortunate practice of applying general principles rather than mid-level principles in the assessment of concrete challenges in treatment and regulation are analyzed. Keywords: conflict, control, consent, commission design, paternalism, political ethics, regulation, self-regulation CiteULike Connotea Del.icio.us What's this?

Biomedical ethics in the FRG is still in an embryonic stage. The Hippocratic tradition of paternalism is still dominant, general debates on Weltanschauungen have not yet been replaced by case-study methods and other means of resolving conflicts more effectively in pluralistic societies. Issues such as IVF and embryo research are predominantly treated in legal rather than in moral terms. Some new developments in moral assessment of prenatal care and care of the dying are reported. Allocational disputes over the future of (...) welfare-state health care systems are likely to continue without any major moral or political decision being reached. (shrink)

First publication of a letter of Albert Einstein to Hans Vaihinger, dated May, 1919, concerning Vaihinger's concept of "Fiktionen", the role of Geometry in Poincaré's system, and the importance of "real culture" in the intellectual's style of life. The letter is introduced and annotated.

This is the first re-publication and first English translation of regulations concerning Human Experimentation which were binding law prior to and during the Third Reich, 1931 to 1945. The introduction briefly describes the duties of the Reichsgesundheitsamt, which formulated these regulations. It then outlines the basic concept of the Richtlinien for protecting subjects and patients on the one hand and for encouraging New Therapy and Human Experimentation on the other hand. Major issues, like personal responsibility of the physician or researcher, (...) teaching of ethics of research and therapy, and research and therapy on vulnerable populations, are compared with the regulations in the Nuremberg Code and subsequent regulations influenced by the Nuremberg Code. CiteULike Connotea Del.icio.us What's this? (shrink)

This paper offers a comparative study of abnormalities in the experience of space, time, and general atmosphere in three psychiatric conditions: schizophrenia, melancholia, and mania. It is a companion piece to our previous article entitled 'Varieties of Self- Experience'; here we focus on experiences of the world rather than of the self. As before, we are especially interested in similarities but also in some subtle distinctions in the forms of subjectivity associated with these three conditions. As before, we survey phenomenologicallyoriented (...) clinical and theoretical accounts as well as patient reports. Experiences involving forms of alienation from the practical and social world and a sense of uncanniness seem to be common in both schizophrenia and affective disorders. But despite some significant similarities, changes in schizophrenic subjectivity appear to be more pervasive and profound, involving experiences of fragmentation, meaninglessess, and ineffable strangeness that are rare or absent in the affective disorders. (shrink)

Previous research has underlined the significance of practical wisdom pertaining to corporate sustainability. Recent studies, however, have identified managing opposing but interlocked tensions related to environmental, social, and economic aspects as one of the most crucial future challenges in CS. Therefore, we apply the established link between wisdom and sustainability to the pressing topic of managing tensions in CS. We commence with a literature overview of tensions in sustainability management, which manifests our basic work assumption concerning the need for practical (...) wisdom in CS. We then discuss the threefold, mutual interconnectedness between practical wisdom and tension management in CS, which we illustrate in a conceptual model. Thereafter, we develop a set of propositions on how a practical wisdom approach influences CS in practice and how it differs from a business-case approach. In recognition of the conceptual character of our paper, we conclude by outlining potential practical applications and theoretical implications of the model and of the propositions. Limitations and avenues for further research are discussed. (shrink)

Although excess blood collection has characterized U.S. national disasters, most dramatically in the case of September 11, periodic shortages of blood have recurred for decades. In response, I propose a new model of medical philanthropy, one that specifically uses charitable contributions to health care as blood donation incentives. I explain how the surge in blood donations following 9/11 was both transient and disaster-specific, failing to foster a greater continuing commitment to donate blood. This underscores the importance of considering blood donation (...) incentives. I defend charitable incentives as an alternative to financial incentives, which I contend would further extend neoliberal market values into health care. I explain my model's potential appeal to private foundations or public–private partnerships as a means for expanding both the pool of blood donors and the prosocial benefit of each act of blood donation. Finally I link my analysis to the empirical literature on blood donation incentives. (shrink)

In an effort to meet growing stakeholder demands for transparency, accountability, and responsibility, many large organizations globally have voluntarily adopted the Global Reporting Initiative guidelines. Moreover, triggered by recent management transgressions, the ancient virtue of practical wisdom has gained increased attention from management scholars, who argue that the Aristotelian concept, with its interdisciplinary nature, has the capacity of turning management back into a holistic, contextual, and virtue-orientated practice. Especially the fact that practical wisdom is firmly based on normative values, coupled (...) with the emphasis on experience and practice, makes it well suited as a leitmotif for sustainable and responsible management. This conceptual paper builds on the link between practical wisdom and sustainability. I argue that the GRI may be regarded as an example of procedural practical wisdom in the context of sustainability reporting, specifically in terms of its emphasis on the holistic and situational dimensions, articulated through the concepts of materiality analysis and stakeholder dialogue. Practical implications, limitations, and avenues for further research are discussed. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.2 (2003) 125-132 [Access article in PDF] Incomprehensibility and Understanding:On the Interpretation of Severe Mental Illness Louis A. Sass Keywords hermeneutics, psychopathology, paradox, Wittgenstein, solipsism, delusion, principle of charity, phenomenological psychopathology. I would like to begin by thanking Rupert Read for the care he has put into reading my work, and into thinking through its implications in the context of the "new-Wittgensteinian" interpretation of the (...) thought of Ludwig Wittgenstein. This interpretation derives from an influential reading of this philosopher's early book, the Tractatus Logico-Philosophicus (1961), that is not explicitly discussed in Read's article, yet that lies behind much of his argument. Read does allude to this reading of the Tractatus when he refers to the concept of "logically alien thought" (see Conant [1992]), and by citing, in his endnotes, the Diamond, Conant, and Cerbone articles that appear in Crary and Read's edited collection, The New Wittgenstein (2000). In an earlier paper that also addresses my work, "On approaching schizophrenia through Wittgenstein," Read (2001) explicitly discusses the relevance of the new-Wittgensteinian interpretation of the Tractatus.According to this new-Wittgensteinian interpretation of the Tractatus, Wittgenstein took absolutely seriously his own realization (explicitly stated at the end of the Tractatus) that his book was internally self-contradictory, and he therefore realized that all or nearly all the sentences of the Tractatus must be totally devoid of any meaning or semantic reference. According to this austere view, the vast bulk of the Tractatus only pretends to be making meaningful statements about the nature of logic and semantics; its real purpose is to give the reader the illusion of meaning, and this it does in order to lead the reader to the eventual realization that there can in fact be no meaningful statements or thoughts at the level of self-referential abstraction at which the Tractatus pretends to be operating. Further, when Wittgenstein (1961) writes (in the famous last line of the book), "Whereof one cannot speak, thereof one must be silent" (p. 189), this statement should, supposedly, not be taken as any kind of mystical pointing toward some ineffable realm or truth, but, rather, as an austere recognition that there just are no ineffable truths—that, so to speak, there just is no mystical there there. [End Page 125]Rupert Read sees an analogy between, on the one hand, the (supposedly mistaken) readers of Wittgenstein's Tractatus who think that Wittgenstein is exploiting self-contradiction to allude to some higher, ineffable truth (i.e., something that can be pointed at even if it cannot be said), and, on the other hand, my own elucidation of Schreber's contradictions (see especially Chapter 2 of Paradoxes of Delusion [1994]) to argue that Schreber can be said to be having particular kinds of experiences, which I refer to as solipsistic or quasi-solipsistic in nature. Just as Wittgenstein's self-contradictions can (supposedly) point nowhere other than to their own failure to mean, so Schreber's self-contradictory and other nonstandard statements cannot (according to Read) be used to illuminate in any meaningful way the form of experience that supposedly lies behind them—as I, for example, have tried to do by offering a phenomenological account of Schreber and schizophrenia. Patients like Schreber and Renée cannot really be understood, just as we cannot really understand logically alien thought—which, in fact, is not really thought at all; in both cases, there is only the illusion of meaning, only the mirage of an alternative mode of thinking or of living. This, at least, is Read's new-Wittgensteinian claim.Few readers of Philosophy, Psychiatry, & Psychology will, I suspect, be familiar with these discussions centering on Wittgenstein's Tractatus, which were introduced largely by the philosophers Cora Diamond and James Conant (see Crary and Read [2000]). (I myself have found their writings fascinating and inspiring in many ways, despite my ultimate disagreement on fundamental issues.) 1 Most readers of Philosophy, Psychiatry, & Psychology will have no way of assessing the validity of this austere reading of the Tractatus... (shrink)

ZusammenfassungTraditionell wird angenommen, Eigenschaften müssten bestimmte Träger besitzen. Wenn es um Handlungen geht, müsste entsprechend ein Agent existieren, der diese Handlungen ausführt. Wendet man dieses naheliegende Bild ins Theologische, gerät man jedoch in all jene Probleme, die wir vom Theismus geerbt haben. Ein revisionärer Atheismus möchte hingegen das ursprüngliche Anliegen, das hinter jenem Bild steckt, bewahren, während das Verhältnis zwischen Gott und seinen Prädikaten und Eigenschaften neu bedacht wird. Dazu ist an Feuerbachs Identifizierung von ‚Gott‘ und ‚Liebe‘ zu erinnern, die (...) im Gespräch mit einigen Wittgensteinschen Stimmen präzisiert wird, um schließlich nach Gottes Wirklichkeit als Wirken an uns zu fragen. Einer Antwort nähern wir uns, indem Gottes Realität für uns mit der eines von uns zu rezipierenden Kunstwerkes analogisiert wird. Gegen die damit gewonnene differenzierte Gleichsetzung von Gott und seinen Eigenschaften stellen sich gewichtige Einwände; diese kommen gegen Ende zu Wort. (shrink)

Here we consider interpersonal experience in schizophrenia, melancholia, and mania. Our goal is to improve understanding of similarities and differences in how other people can be experienced in these disorders, through a review of first-person accounts and case examples and of contemporary and classic literature on the phenomenology of these disorders. We adopt a tripartite/dialectical structure: first we explore main differences as traditionally described; next we consider how the disorders may resemble each other; finally we discuss more subtle but perhaps (...) foundational ways in which the phenomenology of these disorders may nonetheless be differentiated. These involve disruptions of common sense and conventionality, abnormalities of empathy, distinct forms of paranoia and the sense of personal centrality, and altered perceptions of intentionality, deadness, and artificiality. We end by considering some neurocognitive research relevant to these abnormal forms of subjectivity, including work on theory of mind, experience of human movement, and perception of faces. (shrink)

French thought in the twentieth century is typically described as marked by a major fault line, a rupture or grande coupure, that emerged in the 1960s, the heyday of the ‘crisis of the subject.’ Before this time French philosophy, together with associated fields, were focused on issues of subjectivity—first in the vein of Bergsonian vitalism but then shifting, with Sartre and Merleau-Ponty in the late 1930s and 1940s, to forms of phenomenology and existentialism inspired first by Husserl and then, even (...) more decisively, by Heidegger.1 But starting mid-century, developments in the ‘human sciences’ of linguistics, anthropology, and psychoanalysis began to offer a different.. (shrink)

This paper provides a critical survey of some subtle and often overlooked disturbances of self-experience that can occur in schizophrenia, melancholia, and mania. The goal is to better understand both similarities and differences between these conditions. We present classical and contemporary studies, mostly from the phenomenological tradition, and illustrate these with patient reports. Experiential changes in five domains of selfhood are considered: Cognition, Self-Awareness, Bodily Experiences, Demarcation/Transitivism, and Existential Reorientation. We discuss: I. major differences involving self-experience between schizophrenia and affective (...) disorders; II. experiences in which these conditions nevertheless resemble each other; III. suggestions on how these experiences may still differ on a more subtle, phenomenological plane. While affective patients may undergo significant changes in self-experience, their underlying sense of basic or minimal selfhood remains intact. In schizophrenia, basic self is disturbed, and this may help to account for many characteristic disturbances of this disorder. (shrink)

Various forms of anomalous self-experience can be seen as central to schizophrenia and other psychiatric disorders. We examined similarities and differences between anomalous self-experiences common in schizophrenia-spectrum disorders, as listed in the EASE , and those described in published accounts of severe depersonalization. Our aims were to consider anomalous self-experience in schizophrenia in a comparative context, to refine and enlarge upon existing descriptions of experiential disturbances in depersonalization, and to explore hypotheses concerning a possible core process in schizophrenia . Numerous (...) affinities between depersonalization and schizophrenia-spectrum experience were found: these demonstrate that rather pure forms of diminished self-affection can involve many experiences that resemble those of schizophrenia. Important discrepancies also emerged, suggesting that more automatic or deficiency-like factors—probably involving self/world or self/other confusion and erosion of first-person perspective—are more distinctive of schizophrenia-spectrum disorders. (shrink)

Brentano is often considered the originator of the fitting-attitudes analysis of value, on which to be valuable is to be that which it’s fitting to value. But there has been comparatively little attention paid to Brentano’s argument for this analysis. That argument advances the stronger claim that fittingness is part of the analysis of normativity. Since the argument rests on an analogy between truth and fittingness, its impact may seem limited by the idiosyncratic features of Brentano’s later notion of truth. (...) I argue, however, that the Brentanian argument is defensible even if fittingness is analogized to a more typical realist account of truth. The result is what I call the worldly Brentanian account of normativity. I defend this account as a form of naturalistic realism. I then show how the account can fare better than prominent alternatives against two kinds of error-theoretic arguments. (shrink)

This paper offers an intellectual portrait of the French psychoanalyst, Jacques Lacan, by considering his incorporation of perspectives associated with “modernism,” the artistic and intellectual avant-garde of the first half of the twentieth century. These perspectives are largely absent in other alternatives in psychology, psychiatry, and psychoanalysis. Emphasis is placed on Lacan’s affinities with phenomenology, a tradition he criticized and to which he is often seen as opposed. Two general issues are discussed. The first is Lacan’s unparalleled appreciation of the (...) paradoxical nature of human experience, together with his treatment of paradox as almost a criterion of truth. These points are illustrated by considering Lacan’s conceptions of the self and of erotic desire. The second issue is Lacan’s focus on the “ontological dimension,” on overall styles or modalities of what might be termed “transcendental subjectivity”: namely, what he calls the registers of the “Imaginary,” the “Symbolic,” and the “Real.” By emphasizing the incommensurable yet interdependent nature of these modalities, Lacan offers a synthesis of dynamic/conflictual and formal/ontological dimensions of the human condition. This paper offers an encompassing portrait of Lacan’s major ideas that is at odds with the widespread assumption that Lacan is somehow a deeply anti-humanist thinker who derides the subjective dimension. Lacan’s most distinctive contributions are fundamentally concerned with the nature of human experience. They show strong affinities with hermeneutic forms of phenomenology inspired by Heidegger, a philosopher who focused on ontological modes of Being and considered paradox as a mark of truth. (shrink)

This article presents an introductory overview of the interpretations of schizophrenia offered by three phenomenological psychiatrists: Eugene Minkowski (1885-1972), Wolfgang Blankenburg (b. 1928), and Kimura Bin (b. 1931). Minkowski views schizophrenia as characterized by a diminished sense of dynamic and vital connection to the world ("loss of vital contact"), often accompanied by a hypertrophy of intellectual and static tendencies ("morbid rationalism," "morbid geometrism"). Blankenburg emphasizes the patient's loss of the normal sense of obviousness or "natural self-evidence"—a loss of the usual (...) common-sense background that enables normal persons to cope easily with the social and practical world. Kimura focuses on certain distortions of self-experience: a distinctive splitting of the subjective self, alienated awareness of one's own ongoing consciousness, and profound uncertainty about the "I-ness" of the self. In addition to a summary, this article offers a comparison and critique of these three approaches. The three approaches are also considered in light of a more recent, phenomenological formulation of schizophrenia as a disorder of self-experience (an ipseity disturbance) involving hyperreflexivity and diminished self-affection (i.e., heightened awareness of aspects of experience that would normally remain tacit or presupposed and decline in the feeling of existing as a subject of awareness). (shrink)

Schizophrenia involves profound but enigmatic disturbances of affective or emotional life. The affective responses as well as expression of many patients in the schizophrenia spectrum can seem odd, incongruent, inadequate, or otherwise off-the-mark. Such patients are, in fact, often described in rather contradictory terms: as being prone both to exaggerated and to diminished levels of emotional or affective response. According to Ernst Kretschmer, they actually tend to have both kinds of experience at the same time. This paper attempts to explain (...) what might be termed this 'Kretschmerian paradox'. Some relevant concepts and vocabulary for affect and emotion are discussed . The need for a phenomenological approach focusing on subjective experience is suggested. Three modes of abnormal experience in schizophrenia are investigated in light of their implications for affect or emotion: alienation of the lived body ; fragmented perception and loss of affordances ; and preoccupation with a quasi-delusional world created by the self. (shrink)

Zusammenfassung Dies ist eine Antwort auf George Pattisons magistrale Triologie über eine „Philosophy of Christian Life“ – mit Schwerpunkt auf dem zweiten Teil: „A Rhetorics of the Words“. Der Beitrag bietet eine Analyse des zentralen Begriffes, nämlich des „Rufs“ oder der „Berufung“. Dies führt zu drei grundlegenden Fragen nach dem fehlenden Gemeinschaftscharakter der Berufung in Pattisons Darstellung; seiner einseitigen Neigung zum Pessimismus in seiner Kulturkritik; und, der nur marginalen Rolle, die andere Artikulationen als der Ruf innerhalb eines „frommen Lebens“ und (...) seiner ambivalenten Autorität spielen. (shrink)

Some revisionary ontologies are highly parsimonious: they posit far fewer entities than what we quantify over in ordinary discourse. The most radical examples are minimal ontologies, on which physical simples are the only things that exist. Highly parsimonious ontologies, and especially minimal ones, face the challenge of either accounting for the truth of our ordinary quantificational discourse, or paraphrasing such discourse away. Common strategies for addressing this challenge include classical reduction, paraphrase nihilism, and a distinction between ontological and existence commitments. (...) I argue, however, that these strategies are either implausible or fail to provide truth conditions consistent with minimal or parsimonious ontologies. I then discuss, defend, and suggest ways to strengthen an alternative framework for reduction, on which the sentences of reducing theories ground those of reducible theories. Relative to the other options for defending minimal ontology, a strengthened grounding-reductive approach can provide more defensible truth conditions for minimal ontology, better preserve scientific realist intuitions, set a more attainable standard for reduction, and allow our existence commitments to be more responsive to empirical evidence and scientific expertise. As a result, I argue that minimal ontology becomes more defensible—though not certain—on a grounding-reductive framework. But even if minimal ontology were wrong, the grounding-reductive framework makes other parsimonious but non-minimal ontologies more plausible. (shrink)

Wenn Gott keine metaphysische Ergänzung der Welt ist, stellt sich die Frage, wie Gott dann gedacht werden muss, damit wahrhaft von Gott die Rede ist? Hartmut von Sass beantwortet diese Frage, indem er drei Thesen ausarbeitet: dass Gottes Wesen identisch ist mit seinem Handeln; dass dieses Handeln an uns in seiner Offenbarung für uns besteht; und dass dieses offenbarende Handeln in ein neues Selbst- und Weltverständnis des Menschen mündet. Kombiniert man diese drei Thesen, ist Gottes Wirken und damit Gott selbst (...) neu zu verorten: Nicht um einen zur Welt addierten Referenten geht es, sondern um eine irreduzible Referenz auf die uns umgebende Welt. Diese Umstellung vom Denken in Substanzen zum Verstehen in Vollzügen wird als Modalisierung des Glaubens bezeichnet. Den entsprechenden Konsequenzen für einen postmetaphysischen Gottesbegriff geht der Autor im Gespräch mit der Hermeneutischen Theologie und ihren philosophischen Grundlagen nach. (shrink)

A particularly influential thesis about epistemic axiology is veritism: that true belief is the only basic, or fully non-derivative, epistemic value. One recent argument against veritism claims that the naturalness or joint-carvingness of beliefs is also a basic epistemic value. The basic epistemic value of naturalness is held to explain intuitions that true, natural beliefs have greater epistemic value than similar but unnatural beliefs. I argue that epistemic significance, rather than naturalness, can best explain any variations in the value of (...) natural versus unnatural beliefs. Against claims that significance itself undermines veritism, I defend an account of significance that explains why the epistemic value of significance derives entirely from the value of truth. The account also shows how significance can be grounded in multiple features, while still deriving all its value from that of truth. As a result, the epistemic value of natural beliefs offers little reason to abandon veritism, in the absence of stronger arguments favoring the basic epistemic value of naturalness. (shrink)

This paper uses certain of Michel Foucault's ideas concerning modern consciousness (from The Order of Things) to illuminate a central paradox of the schizophrenic condition: a strange oscillation, or even coexistence, between two opposite experiences of the self: between the loss or fragmentation of self and its apotheosis in moments of solipsistic grandeur. Many schizophrenic patients lose their sense of integrated and active intentionality; even their most intimate thoughts and inclinations may be experienced as emanating from, or under the control (...) of, some external being or mysterious foreign soul (‘I feel it is not me who is thinking’; ‘I have been programmed’). Yet the same patients may also experience the self as preeminent, all-powerful or all-knowing (‘My thoughts can influence things’; ‘This event happens because I think it'). Here one may feel confronted with the very paradigm of irrationality: profound contradictions suggesting regression to primitive ‘primary-process’ thinking or utter collapse of the higher faculties of mind. I argue, however, that these dualities so basic to schizophrenia can best be understood very differently: as consequences of a kind of alienation and hyper-self-consciousness (‘hyper- reflexivity') that is closely analogous to what occurs in the post-Kantian era of Western intellectual history. The parallel dualities of modern thought have been most extensively discussed by Foucault, who describes paradoxes, tensions and other dilemmas central to what he calls the modern ‘episteme'; these result from what Foucault sees as the modern human being's introverted and ultimately self-deceiving preoccupation with, and overvaluing of, the phenomenon of his own consciousness. Parallels between these contradictions and those characteristic of several withdrawn schizophrenic individuals are described and analysed. The paper concludes with an Afterword in which some possible neurobiological underpinnings of these schizophrenic experiences are discussed. (shrink)

This paper considers the ethical risks and opportunities presented by generalist medical artificial intelligence (GMAI), a kind of dynamic, multimodal AI proposed by Moor et al. (2023) for use in health care. The research objective is to apply widely accepted principles of biomedical ethics to analyze the possible consequences of GMAI, while emphasizing the distinctions between GMAI and current-generation, task-specific medical AI. The principles of autonomy and health equity in particular provide useful guidance for the ethical risks and opportunities of (...) novel AI systems in health care. The ethics of two applications of GMAI are examined: enabling decision aids that inform and educate patients about certain treatments and conditions, and expanding AI-driven diagnosis and treatment recommendation. Emphasis is placed on the potential of GMAI to improve shared decision-making between patients and providers, which supports patient autonomy. Another focus is on health equity, or the reduction of health and access disparities facing underserved populations. Although GMAI presents opportunities to improve patient autonomy, health literacy, and health equity, premature or inadequately regulated adoption of GMAI has the potential to compromise both health equity and patient autonomy. On the other hand, there are significant risks to health equity and autonomy that may arise from not adopting GMAI that has been thoroughly validated and tested. A careful balancing of these risks and benefits will be required to secure the best ethical outcome, if GMAI is ever employed at scale. (shrink)